Do you apply for paediatric fellowships in PGY-3 or PGY-4?

[lovemedicinesomuch]

I heard that in the upcoming years, people will have to complete 4 years of paediatrics prior to applying to fellowship. Is that true?

Thanks!

[bearded frog]

Yes, while historically you could apply after 3 years or 4 years in most circumstances, starting with this year's current pediatric R1s, you can only apply to fellowship after your 4th year. They're also moving the board exam up a bit. This had the full support of fellowship program directors as fellows who started in their 4th year would have to right the board exam during the first year of fellowship, which is quite distracting.

[mmiinterviewprep]

36 minutes ago, bearded frog said:

Yes, while historically you could apply after 3 years or 4 years in most circumstances, starting with this year's current pediatric R1s, you can only apply to fellowship after your 4th year. They're also moving the board exam up a bit. This had the full support of fellowship program directors as fellows who started in their 4th year would have to right the board exam during the first year of fellowship, which is quite distracting.

interesting! I wonder if that would dissuade people from applying to peds.. because now it will take 1 additional extra year to apply to peds sub-specialties, whilst in IM you can apply  whilst you are in your 3rd year. 

[CaRMS2021]

10 hours ago, mmiinterviewprep said:

interesting! I wonder if that would dissuade people from applying to peds.. because now it will take 1 additional extra year to apply to peds sub-specialties, whilst in IM you can apply  whilst you are in your 3rd year. 

I feel like the Venn diagram of ppl applying to peds and IM are two circles lol

[Lavarball]

So are peds sub specialties going to turn into 6 yrs total, while some IM sub specialties can be finished in 5?

[Redpill]

2 hours ago, CaRMS2021 said:

I feel like the Venn diagram of ppl applying to peds and IM are two circles lol

I don't think this is true. I saw a number of applicants on my Peds core rotation who were planning to apply to both Peds and IM. I think they both wanted Peds more actually, but ended up in IM

[Snowmen]

So applying to a peds subspecialty means taking a pay cut and training for two more years. Interesting.

[zoxy]

Pediatric Cardiology, Heme-Onc, and Neurology have three year fellwoships so will be 7 years of training in total. A pediatric cardiologist with an additional year of advanced heart failure and transplant training will have 8 years of training. The UdeM pediatric structural and interventional cardiology super-fellowship is two years so that would be 9 years of training! And that's without any research years during residency.

Anyway, it's somewhat funny that in surgery and rads they're trying to decrease training length by introducing integrated Cardiac, Vascular, Interventional Radiology and Plastics training, but  Medicine and Peds want to shackle their trainees into their 40's. 

[lovemedicinesomuch]

1 hour ago, Snowmen said:

So applying to a peds subspecialty means taking a pay cut and training for two more years. Interesting.

This is quite unfortunate. A lot of time paediatricians are almost paid similar to family doctors  despite the difference in years of training ( 2 years vs 5 yrs), and now they plan to extend their training... that makes no sense.

[zoxy]

3 minutes ago, lovemedicinesomuch said:

that makes no sense

Welcome to academic medicine.

[shikimate]

Perhaps this will create more pediatric generalists, which I think might not be a bad idea. As much as it's nice to have sub-specialists available it's kinda unfortunate that a lot of IM/peds sub-specialist stop practicing GIM/general peds after fellowship. It's always nice to have generalists in the community who knows bit about everything but also have special interests in some areas.

I once told a staff (a smart respectful guy, not an academic doorknob) that maybe I'll practice for a bit then apply for fellowship if I am not successful on the first try. He chucked, and said once you start practicing you'll never wanna go back to residency/fellowship. I thought he was joking but to be honest he's kinda right. Like I am no specialist but I get paid the same (and probably more), and I'd say in <6 months I basically lost all motivation to ever go back to do fellowship. 

My co-resident was the same. We were both pretty hard core trying to get fellowship, but once we start practice in no time we lost all desire to ever go back to academia.

[bearded frog]

To be fair, with CBD implementation and without the first year of fellowship being a write-off for many fellows, perhaps the length of some fellowships will be adjusted. Also the "pay cut" for subspeciality is not the same as it is in the US, the bottleneck is open positions for specialties that require hospital affiliation in places people want to live.

All that being said, I chose gen peds for a reason lol

[zoxy]

15 hours ago, bearded frog said:

perhaps the length of some fellowships will be adjusted

I can't see many of the fellowships going from 2 years to one. Would one year be enough for peds-GI, or peds-nephro?

[bearded frog]

20 minutes ago, zoxy said:

I can't see many of the fellowships going from 2 years to one. Would one year be enough for peds-GI, or peds-nephro?

Probably not, but maybe some of the 3 year ones could be shorter.